title: Home-centred physical fitness programme in morbidly obese individuals: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of domiciliary physical fitness programmes in obese individuals.
  
  
  METHODS
  Nine-month randomized controlled trial.
  
  
  METHODS
  Home-based intervention with outpatient visits.
  
  
  METHODS
  Morbidly obese subjects (body mass index (BMI) > or = 30) aged 25-65 years suitable for physical activities at home.
  
  
  METHODS
  At the end of a preliminary one-month in-hospital rehabilitation programme (baseline), 52 patients were randomly assigned either to a structured educational programme (intervention group) of daily incremental physical activity at home (walking and skeletal muscle resistance training, with booklets and written instructions) or to a programme of general advice (control group) regarding exercise and long-term fitness.
  
  
  METHODS
  Both groups were evaluated at baseline and every three months for: (1) time, metabolic equivalents (METs), and heart rate reserve (HRR) during a standardized 2-km walking test (2kmWT); (2) anthropometric measures (body weight, BMI, abdominal and neck circumference); (3) the Polar Fitness Test index (PFTI), and (4) time to exhaustion while sustaining consecutive isoload extensions in the dominant leg (isoload LE). Time during 2kmWT was the study primary outcome.
  
  
  RESULTS
  Body weight, BMI and abdominal circumference improved significantly (P < 0.05) over time in the intervention group. The cardiopulmonary fitness variables changed significantly (P < 0.05) over time in both study groups. However, all variables improved in the intervention patients, while some worsened or remained stable in the controls. Thus, the mean group difference in changes was significant (P < 0.05) for 2kmWT time (-77.4 seconds), HRR (11.7%), and PFTI (5.4 points).
  
  
  CONCLUSIONS
  This structured domiciliary fitness programme is feasible and provides sustained anthropometric and physiological benefits in some morbidly obese individuals.
authors.affiliation: Ospedale Villa Pineta and University of Modena, Department of Pulmonary Rehabilitation, Pavullo MO, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Tumiati
authors.forename: Gianni
authors.initials: G
authors.lastname: Mazzoni
authors.forename: Ernesto
authors.initials: E
authors.lastname: Crisafulli
authors.forename: Barbara
authors.initials: B
authors.lastname: Serri
authors.forename: Claudio
authors.initials: C
authors.lastname: Beneventi
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Lorenzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grazzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Prato
authors.forename: Francesco
authors.initials: F
authors.lastname: Conconi
authors.forename: Leonardo M
authors.initials: LM
authors.lastname: Fabbri
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Clini
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D016001:Confidence Intervals; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D055686:Metabolic Equivalent / Q000502:physiology*; D008875:Middle Aged; D053580:Muscle Strength; D009767:Obesity, Morbid / Q000628:therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic; D010809:Physical Fitness / Q000502:physiology*; D055070:Resistance Training; D012648:Self Care / Q000592:standards*; D016138:Walking; D015431:Weight Loss